Anemia

Anemia is a condition of lower-than-normal red blood cell (RBC) count and hemoglobin (Hgb) level. It is often not a specific disease state but a sign of an underlying disorder. Anemia results in a diminished amount of oxygen delivery to body tissues. There are many different kinds of anemia, but all can be classified as being due to a decrease in the production of RBC’s (hypoproliferative), excessive destruction of RBC’s (hemolytic), or a loss of RBC’s (eg. gastrointestinal bleeding). Other etiologic factors include deficits in iron and nutrients, hereditary factors, and chronic diseases. Complications of severe anemia include heart failure, paresthesias, confusion, and other problems specific to type of anemia.

CLINICAL MANIFESTATIONS

Several factors influence symptom of development from anemia, including its severity, speed of development (the faster the onset, the more severe the symptoms), and duration (eg. its chronicity; long-term anemia may produce few or no symptoms); the patient’s metabolic requirements and concurrent disorders or disabilities (eg. cardiopulmonary disease); and special complications or features of the condition that produced the anemia. Pronounced symptoms of anemia include the following:

Anemia is the most common hematologic condition affecting elderly people. In this population, bone marrow typically has a decreased ability to respond to the body’s need for blood cells. The inability to increase blood cell production adequately in cases of increased need seriously affects cardiopulmonary function. Because elderly people with a concurrent cardiac or pulmonary problem may be unable to tolerate anemia, a prompt, through evaluation of the anemia is warranted.

MEDICAL MANAGEMENT

The goal is to correct or control the cause of the anemia and replace lost or destroyed RBC’s by transfusing packed RBC’s. In elderly patients it is important to identify and treat the cause of anemia rather than considering it a consequence of aging.